This amended competing renewal application 2 R01 HL25767-28 proposes to continue our investigations of the psychobiological pathways connecting socioeconomic status (SES) with cardiovascular risk disease (CVD) factors in adolescence. In our most recent work, we have concentrated on understanding pathways leading to vascular stiffness and high blood pressure (BP). Because of the emerging epidemic of obesity and pre-clinical Type II diabetes in adolescence, we are changing the focus in the next stage of the research program to the metabolic syndrome and its component risk factors, especially central adiposity, elevated glucose (and insulin), and overall BP burden, as estimated by average daytime and nighttime BP and their ratio. Our most recent research suggests that several behavioral risk factors may have spillover effects onto nighttime physiology. Therefore, we are also planning to evaluate sleep disturbance in two ways: as a potential consequence of behavioral risk factors;and as a factor contributing to the metabolic syndrome and to elevated nighttime BP. Our proposed project will use the Reserve Capacity Model as an organizational framework. We plan to enroll into Project Pressure 250 adolescents (14 to 16 years of age), half high and half low SES families based on parental education and occupation. The sample will be composed of half African American and European American, and half male and half female adolescents. Each teenager will participate in two days and nights of ambulatory BP monitoring accompanied by diary ratings of positive and negative circumstances at the time of each daytime BP assessment. For one week, they will wear a wrist actigraph to measure sleep duration and fragmentation during school and weekend nights;and they will complete a short diary each morning and evening regarding key positive and negative experiences that day and quality of sleep. A blood draw and measurement of waist and hip circumference will allow calculation of the metabolic syndrome. The Reserve Capacity Model will be evaluated in a cross-sectional manner in the proposed project period. Should the Reserve Capacity model prove consistent with our cross-sectional data, we will propose in a later grant application to follow the sample for the predictors of change in CVD risk. PUBLIC HEALTH RELEVANCE: We propose to test if adolescents from low socioeconomic status (SES) backgrounds are at elevated risk for the metabolic syndrome, high nighttime blood pressure and sleep disturbance. To the extent SES is related to these precursors of diabetes and heart disease, we also will identify key psychobiological pathways connecting early SES to later health. The research has the potential of understanding the basis of adolescent health disparities.